WORKERS COMPENSATION PROGRAM MARINE CORPS COMMUNITY SERVICES CAMP LEJEUNE-NEW RIVER, NC

WORKERS COMPENSATION PROGRAM MARINE CORPS COMMUNITY SERVICES CAMP LEJEUNE-NEW RIVER, NC

APPLICABILITY: Provisions of the Longshore & Harbor Workers Compensation Act (LHWCA) apply to benefits for disability or death resulting from an on~ the-job injury or occupational disease to: Employees Authorized volunteers

BENEFITS AUTHORIZED: MCCS employees eligible for: Medical services Medical Supplies Medicines Compensation

COVERAGE: LHWCA covers employees: From the time they report for duty until the time they leave at the end of working hours. While traveling away under orders of temporary duty or while traveling locally at the direction of the employer, unless the employee deviates from the scope of employment. LHWCA does not normally cover an employee while they are traveling to and from work. Compensation may be denied if the injury was due solely to intoxication, horseplay or resulted from a willful intent to injure or kill oneself or another.

EMPLOYEE S CHECKLIST: If a Work Injury/Illness Occurs: Notify your supervisor immediately! If seeking medical and it is not an emergency: 1. Go to Human Resources and get an LS-1 for authorizing medical treatment to your doctor. 2. Have supervisor fill out Occupational Health Form and go to Bldg 65 Inform the doctor that this is a workers compensation claim. Keep in contact with your supervisor regarding your recovery & work status. Keep in contact with your Contract Claims Services, Inc. (CCSI) claims adjuster and HR.

SUPERVISOR S CHECKLIST: If a Work Injury/Illness Occurs: 1. Arrange for emergency medical treatment for the employee if required 2. or, Fill out Occupational Health Form and send employee to Bldg 65. (Then employee need to report to HR) 3. or, Send them to HR to fill out LS1 to be seen by their Dr. Inform Human Resources within 24 hours of injury/illness accrues. Complete the Incident Report: http://www.mccslejeune.com/hr/forms/html Keep in contact with the injured employee and document all telephone conversation/meetings/emails/text, etc. Keep HR informed of the injured employee s work status and their return to work date. Forward any medical documentation to HR.

SUPERVISOR S CHECKLIST CONT: If the injured worker is released to return to work, has restrictions, It is mandatory now to follow the Return-to-Work policy. ESAMS does not take the place of an Incident Report. ESAMS is separate from workers comp. Once completed, you can email, fax and/or deliver the report to: Ms. June Schmelter schmelterjf@usmc-mccs.org Phone: (910) 451-2047 Fax: (910) 450-7964

PAYROLL TIMEKEEPING: EXAMPLES: FT Employee out on WC LN-2/3 WC 5.33 SO or VO 1/3 2.67 8.00 PT Employee out on WC Employee working ½ day due to WC LN 2/3 WC 4.00 WO 4.00 SO or VO 1/3 2.00 LN 2/3 WC 2.66 6.00 SO or VO 1/3 1.34 8.00 (SO NEEDS TO BE USED FIRST BEFORE USING VO)

WILLFUL FALSE STATEMENTS: Any employee /claimant or employee's representative who knowingly and willfully makes a false statement to obtain benefits under the Act is guilty of a felony and If convicted, they will be punished by a fine not to exceed $11,000 and/or imprisonment not to exceed five years. Any person or employer who knowingly and willfully makes a false statement for the purpose of reducing, denying, or terminating benefits to an injured employee may be fined and/or imprisoned.

PENALTIES / FINES: When compensation or claims are not paid or filed in a timely manner, the employer can be assessed a fine or penalty and they are listed below: $11,000 Fine. A fine will be assessed by DOL if an employer/carrier knowingly and willfully fail or refuse to file within 10 days from the date of injury, or from the date the employer had knowledge of the injury. 10% Penalty. Assessed for failure to pay compensation on time. If compensation is not paid or controverted within 14 days after the disability begins.

THINGS TO REMEMBER An incident report is filled out when an employee comes to you and says they were injury at work Supervisors fill out incident reports. If you need to have the employee write a separate statement that s fine. If an employee does not wish to file a workers comp claim, have them write a statement on the bottom of the incident report.

INJURY/ILLNESS REPORTING PROCESS Employee is Injured/Illness on Job Fill out Incident Report Form within 24 hours and send Fax 450-7964 or, Email schmelterjf@usmc-mccs.org or, Hand deliver to MCCS HR Bldg 1401 Employee wants to seek medical. They have a choose where to go. 1. Occupation Health Fill Occupational Health form before sending 2. Employee s own physician Need to get authorization from HR first 3. ER at any Hospital This will be considered a medical claim. All doctors notes must be sent to HR & supervisor each time employee go to the doctor Employee does not want to seek medical. Have employee sign a statement on the bottom of the incident report. This will be filed as an incident only. Employee is put on light duty due to injury/illness It is mandatory that the division accommodate the employee

CERTIFICATE OF COMPLETION THIS CERTIFIES THAT has successfully completed Workers Compensation 2015 Employee Signature Employee ID#